Glacier Non Resident Alien Tax

AN APPOINTMENT WITH PAYROLL IS REQUIRED Please contact Kristina Racher Phone: (330) 672-8641 E-mail: [email protected]

GLACIER Account Setup Information (Use this form for employees attending Kent State University on a Visa)

Job Title or Description:

Do you have a Social Security Number or ITIN? YES NO

BANNER ID:

Please use the name that is on your Social Security Card. Please print legibly.

Name (First):

(Middle):

(Last or Family):

Please use your Kent.edu address:

E-mail Address:

Phone Number:

RETURN THIS COMPLETED FORM DURING YOUR APPOINTMENT:

Kent State University Payroll Department Attn: Kristina Racher P.O. Box 5190 236 Schwartz Center Kent, OH 44242 Please call 330-672-8641 with questions

Payroll Use Only:

Rec’d & Entered:

Rev. 08/06/2013